Samuraki Miharu, Matsunari Ichiro, Yoshita Mitsuhiro, Shima Keisuke, Noguchi-Shinohara Moeko, Hamaguchi Tsuyoshi, Ono Kenjiro, Yamada Masahito
Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan.
Clinical Research Department, the Medical and Pharmacological Research Center Foundation, Hakui, Ishikawa, Japan.
J Alzheimers Dis. 2015;48(2):517-28. doi: 10.3233/JAD-150274.
Microbleeds (MBs) are frequently observed in Alzheimer's disease (AD); however, the relevance to AD pathophysiology has not been elucidated.
We investigated correlation of MBs, especially cerebral amyloid angiopathy (CAA)-related MBs with cognitive function, gray matter volume, and glucose metabolism in AD.
We performed magnetic resonance imaging including T2*-weighted imaging sequence for 206 patients with AD. Among them, 158 AD patients with no focal brain lesions except for MBs were investigated with cognitive tests, voxel-based morphometry, and 18F-fluorodeoxyglucose positron emission tomography in a cross-sectional observational study.
Of the 158 patients with no hemorrhagic and/or ischemic stroke lesions except for MBs, 27 patients had MBs, in which 17 patients showed CAA-related MBs that located only in cortex/subcortex (CAA-related MBs), and 10 patients showed CAA-unrelated MBs that located in deep regions regardless of the presence of MBs in cortical/subcortical regions. There were slightly but significant differences in cognitive functions between the patients without MBs, those with CAA-related MBs, and those with CAA-unrelated MBs. MBs were recognized frequently in the occipital lobe in the patients with CAA-related MBs. The patients with CAA-related MBs showed gray matter atrophy in the temporal lobe and cerebellum, and glucose hypometabolism in the temporal lobe compared with those without MBs.
Our results indicate that MBs, particularly CAA-related MBs would cause gray matter atrophy and glucose hypometabolism in AD.
微出血（MBs）在阿尔茨海默病（AD）中经常被观察到；然而，其与AD病理生理学的相关性尚未阐明。
我们研究了MBs，尤其是与脑淀粉样血管病（CAA）相关的MBs与AD患者认知功能、灰质体积和葡萄糖代谢的相关性。
我们对206例AD患者进行了包括T2 *加权成像序列在内的磁共振成像检查。在一项横断面观察研究中，对其中158例除MBs外无局灶性脑病变的AD患者进行了认知测试、基于体素的形态学测量和18F-氟脱氧葡萄糖正电子发射断层扫描。
在158例除MBs外无出血性和/或缺血性中风病变的患者中，27例有MBs，其中17例显示仅位于皮质/皮质下的CAA相关MBs（CAA相关MBs），10例显示与CAA无关的MBs，位于深部区域，无论皮质/皮质下区域是否存在MBs。无MBs的患者、有CAA相关MBs的患者和有CAA无关MBs的患者在认知功能上存在轻微但显著的差异。在CAA相关MBs的患者中，枕叶经常出现MBs。与无MBs的患者相比，CAA相关MBs的患者在颞叶和小脑出现灰质萎缩，在颞叶出现葡萄糖代谢减低。
我们的结果表明，MBs，尤其是与CAA相关的MBs会导致AD患者的灰质萎缩和葡萄糖代谢减低。
